GRFS and CRFS in alternative donor hematopoietic cell transplantation for pediatric patients with acute leukemia
PublisherAmerican Society of Hematology
MetadataShow full item record
AbstractWe report graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) (a composite end point of survival without grade III-IV acute GVHD [aGVHD], systemic therapy-requiring chronic GVHD [cGVHD], or relapse) and cGVHD-free relapse-free survival (CRFS) among pediatric patients with acute leukemia (n = 1613) who underwent transplantation with 1 antigen-mismatched (7/8) bone marrow (BM; n = 172) or umbilical cord blood (UCB; n = 1441). Multivariate analysis was performed using Cox proportional hazards models. To account for multiple testing, P < .01 for the donor/graft variable was considered statistically significant. Clinical characteristics were similar between UCB and 7/8 BM recipients, because most had acute lymphoblastic leukemia (62%), 64% received total body irradiation-based conditioning, and 60% received anti-thymocyte globulin or alemtuzumab. Methotrexate-based GVHD prophylaxis was more common with 7/8 BM (79%) than with UCB (15%), in which mycophenolate mofetil was commonly used. The univariate estimates of GRFS and CRFS were 22% (95% confidence interval [CI], 16-29) and 27% (95% CI, 20-34), respectively, with 7/8 BM and 33% (95% CI, 31-36) and 38% (95% CI, 35-40), respectively, with UCB (P < .001). In multivariate analysis, 7/8 BM vs UCB had similar GRFS (hazard ratio [HR], 1.12; 95% CI, 0.87-1.45; P = .39), CRFS (HR, 1.06; 95% CI, 0.82-1.38; P = .66), overall survival (HR, 1.07; 95% CI, 0.80-1.44; P = .66), and relapse (HR, 1.44; 95% CI, 1.03-2.02; P = .03). However, the 7/8 BM group had a significantly higher risk for grade III-IV aGVHD (HR, 1.70; 95% CI, 1.16-2.48; P = .006) compared with the UCB group. UCB and 7/8 BM groups had similar outcomes, as measured by GRFS and CRFS. However, given the higher risk for grade III-IV aGVHD, UCB might be preferred for patients lacking matched donors.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85068626630&doi=10.1182%2fbloodadvances.2018030171&partnerID=40&md5=131f994328a326ca2e88fdd5cd40fc78; http://hdl.handle.net/10713/10649
- Superior GVHD-free, relapse-free survival for G-BM to G-PBSC grafts is associated with higher MDSCs content in allografting for patients with acute leukemia.
- Authors: Fan Q, Liu H, Liang X, Yang T, Fan Z, Huang F, Ling Y, Liao X, Xuan L, Xu N, Xu X, Ye J, Liu Q
- Issue date: 2017 Jul 4
- Composite GRFS and CRFS Outcomes After Adult Alternative Donor HCT.
- Authors: Mehta RS, Holtan SG, Wang T, Hemmer MT, Spellman SR, Arora M, Couriel DR, Alousi AM, Pidala J, Abdel-Azim H, Agrawal V, Ahmed I, Al-Homsi AS, Aljurf M, Antin JH, Askar M, Auletta JJ, Bhatt VR, Chee L, Chhabra S, Daly A, DeFilipp Z, Gajewski J, Gale RP, Gergis U, Hematti P, Hildebrandt GC, Hogan WJ, Inamoto Y, Martino R, Majhail NS, Marks DI, Nishihori T, Olsson RF, Pawarode A, Diaz MA, Prestidge T, Rangarajan HG, Ringden O, Saad A, Savani BN, Schoemans H, Seo S, Schultz KR, Solh M, Spitzer T, Storek J, Teshima T, Verdonck LF, Wirk B, Yared JA, Cahn JY, Weisdorf DJ
- Issue date: 2020 Jun 20
- Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis.
- Authors: Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang MJ, Arcese W, Sirvent A, Champlin RE, Chao N, Gee AP, Isola L, Laughlin MJ, Marks DI, Nabhan S, Ruggeri A, Soiffer R, Horowitz MM, Gluckman E, Wagner JE, Center for International Blood and Marrow Transplant Research., Acute Leukemia Working Party Eurocord (the European Group for Blood Marrow Transplantation)., National Cord Blood Program of the New York Blood Center.
- Issue date: 2010 Jul
- Impacts of thymoglobulin in patients with acute leukemia in remission undergoing allogeneic HSCT from different donors.
- Authors: Wakamatsu M, Terakura S, Ohashi K, Fukuda T, Ozawa Y, Kanamori H, Sawa M, Uchida N, Ota S, Matsushita A, Kanda Y, Nakamae H, Ichinohe T, Kato K, Murata M, Atsuta Y, Teshima T, GVHD Working Group of the Japan Society for Hematopoietic Cell Transplantation.
- Issue date: 2019 Jan 22
- Effect of graft source on unrelated donor hemopoietic stem cell transplantation in adults with acute myeloid leukemia after reduced-intensity or nonmyeloablative conditioning: a study from the Société Francaise de Greffe de Moelle et de Thérapie Cellulaire.
- Authors: Malard F, Milpied N, Blaise D, Chevallier P, Michallet M, Lioure B, Clément L, Hicheri Y, Cordonnier C, Huynh A, Yakoub-Agha I, Peffault de Latour R, Mohty M
- Issue date: 2015 Jun